The ability to predict whether burn wounds will heal spontaneously or will require skin grafting is important because of increasing utilization of primary excision and grafting. This study prospectively evaluated the ability of heated laser Doppler flow measurements obtained in the first 48 hours after burn injury to predict whether burn wounds would heal within 3 weeks. Further, the severity of scarring at 3 months was compared with the initial measurements. The measurements predicted healing with 100 percent accuracy and failure to heal with 93 percent accuracy. There was also a significant correlation between initial flow measurements and severity of scarring at 3 months. We conclude that heated laser Doppler flow measurements performed early after burn injury are useful in predicting whether healing is likely to occur, as well as the quality of late scar formation; therefore, the method is useful in selecting patients for primary excision and grafting of burn wounds.